Understanding ovarian reserve: Why it matters for your fertility
Guides
31 May 2025
Valuable insights into your fertility
When you’re trying to conceive or thinking about having children, understanding your fertility can feel overwhelming.
One key aspect of female fertility is your ovarian reserve. This basically means the number of eggs left in your ovaries. Knowing your ovarian reserve can provide valuable insights and help you plan your family.
This article covers what ovarian reserve is, why it’s essential, and how you can check it through specific fertility tests for women.
Ovarian reserve is the number of eggs you have in your ovaries at any given time. You are born with all the eggs you will ever have: around one to two million. By puberty, that number drops to about 300,000 to 500,000.
Each month, several structures (small sacs) in your ovaries, called follicles, start to grow. These follicles contain immature eggs.
Usually, only one egg fully matures and is released during ovulation. The rest break down and are reabsorbed, slowly reducing your egg count over time.
Knowing your ovarian reserve helps you understand the current status of your fertility. It can be a helpful guide when planning pregnancy and your future family.
Why is ovarian reserve important?
Knowing your ovarian reserve helps you:
Understand your current fertility status
Plan when to try for a baby
Identify possible fertility challenges early
Discuss fertility preservation options if needed
It’s important to know your ovarian reserve because as we have seen, fertility declines as you age. Your peak reproductive years are between your late teens and late 20s, andfertility gradually declines in your 30s, significantly after age 35.
Understanding your ovarian reserve allows you to make timely decisions about conception and fertility treatments, reducing stress and potential heartache later.
How to check ovarian reserve
There are a few different tests your doctor can use to check your ovarian reserve. These tests look at your hormone levels and the number of follicles visible on an ultrasound to give a sense of how many eggs you may have left.
Antral follicle count
An antral follicle count is a simple, painless ultrasound done through the vagina. It lets your doctor count the number of small follicles (called antral follicles) in your ovaries. Each of these “tiny sacs” has the potential to grow into a mature egg during your cycle.
A higher number of antral follicles usually means you have a better ovarian reserve. This means your ovaries are likely to respond well to fertility treatments if needed. The test is usually done early in your menstrual cycle and gives results right away, so you can quickly get a clearer picture of your fertility.
Blood test for follicle stimulating hormone (FSH)
This is a simple blood test that measures the level of follicle-stimulating hormone (FSH) in your body. FSH helps your ovaries grow and mature eggs, which is why it plays an important role in your fertility.
The test is usually done on day 3 of your menstrual cycle. If your FSH level is high, it may mean your ovaries are working harder than usual to grow eggs, which can be a sign of a lower ovarian reserve.
On the other hand, lower FSH levels often suggest better fertility potential. Your doctor will look at these results alongside other tests to get a fuller picture of your reproductive health.
This hormone is produced by the small follicles in your ovaries – the same ones that hold immature eggs. The amount of AMH in your blood gives a good indication of how many eggs you may have left, which is why it is often used to check your ovarian reserve.
Higher AMH levels usually mean you have more follicles and a better egg supply. Lower levels can suggest a reduced ovarian reserve, which might make it harder to get pregnant.
However, it is important to know that AMH only tells you about quantity, not quality, so even with low AMH, you can still have healthy eggs and get pregnant.
One of the benefits of the AMH test is that it can be done at any point in your menstrual cycle. That makes it more flexible and convenient than some other hormone tests. It is often one of the first tests doctors recommend when checking fertility, especially before IVF or egg freezing.
It is worth keeping in mind that AMH levels naturally decline with age, and results can vary slightly between labs. Your doctor will always interpret your AMH level alongside other factors like age, cycle history, and ultrasound findings to give you the clearest picture of your fertility.
Good ovarian reserve – what does it mean?
If you have a good ovarian reserve, it means you still have a healthy number of eggs. That usually gives you more time and can make it easier to get pregnant.
One way doctors check this is by counting the small follicles in your ovaries, called antral follicles. A total of 10 to 20 across both ovaries is generally considered a good sign. They will also look at your hormone levels. Higher AMH and lower FSH usually suggest your ovaries are still working well.
Low ovarian reserve – what does it mean?
Low ovarian reserve means there are fewer eggs left in your ovaries. It does not always mean infertility, but it might mean you have less time to conceive naturally.
A lower antral follicle count, usually fewer than five in total, may suggest reduced fertility. But these numbers vary from person to person, and your doctor will also consider your age, hormone levels, and overall health.
Having a low ovarian reserve does not always mean you will go through early menopause, but it can be one of the signs.
Menopause is when your periods stop for good, and you can no longer get pregnant naturally. It happens because your ovaries have stopped releasing eggs and producing the hormones needed for a regular menstrual cycle. Most women reach menopause around the age of 51, though the timing can vary.
If your ovarian reserve is very low, your body may run out of eggs sooner, which can lead to earlier menopause. However, this is not guaranteed. Many women with a low egg count continue having regular cycles for years.
The timing of menopause depends on many things, including:
Your genetics (when your mother or sisters reached menopause)
Your overall health
Whether you smoke
Certain medical conditions or treatments (like chemotherapy)
If you are concerned about early menopause or changes in your cycle, a fertility specialist can help you understand your hormone levels and what they might mean for your future fertility.
How can I improve my ovarian reserve?
While you can’t increase the number of eggs you were born with, looking after your reproductive health can still support your fertility.
There are no proven ways to restore or boost ovarian reserve, but you can take steps that may improve how your body responds to treatment and ovulation:
Get regular exercise
Maintain a healthy weight
Avoid smoking and limit alcohol
Manage stress levels
Eat a nutritious, balanced diet
These lifestyle changes will not increase your egg count, but they can support your overall fertility and improve your chances of conception.
Is ovarian reserve linked to egg quality?
Ovarian reserve tells you how many eggs you have, but it does not measure egg quality. These are two different things, and both are important for fertility.
So, what is egg quality?
Egg quality refers to whether an egg has the right number of chromosomes and enough energy to grow into a healthy embryo. High-quality eggs are more likely to fertilise, implant, and lead to a healthy pregnancy. Poor-quality eggs may not fertilise at all or can lead to miscarriage orfailed IVF cycles.
Can egg quality be measured?
Unlike egg quantity, there is no simple test to measure egg quality directly. Age is the best general guide. Egg quality naturally declines with age, especially after 35 and more quickly after 40. That’s why age is often such a big factor in fertility treatment planning.
Sometimes, if you go throughIVF, doctors can get clues about egg quality based on how your eggs fertilise and develop. But this only gives an indirect sense, not a definite answer.
Can anything improve egg quality?
While you can’t change your age, youcan support the health of your eggs. While nothing can guarantee better egg quality, some changes may help your eggs function as well as possible:
Eat a nutrient-rich diet with plenty of antioxidants
Avoid smoking and reduce alcohol
Get regular, moderate exercise
Maintain a healthy body weight
Take fertility-supportive supplements like CoQ10 (always speak to your doctor first)
Keep stress levels in check where you can
These changes may support your eggs’ energy, development, and ability to fertilise, especially if you are planning fertility treatment.
How does egg quality affect fertility?
Even if you have a good number of eggs, low quality can make it harder to get pregnant or stay pregnant. On the flip side, some people with low ovarian reserve still conceive successfully, because they still have some good-quality eggs.
That is why both egg quality and quantity matter, and why it helps to speak to a specialist to understand your full fertility picture.
How fertility treatments like IVF and egg freezing can help
If you have a low ovarian reserve or are thinking about future fertility, treatments like IVF and egg freezing can give you more options and control over your reproductive journey.
In vitro fertilisation (IVF)
IVF is one of the most effective fertility treatments available. It is often recommended when ovarian reserve is low, when you are over 35, or when other treatments have not worked.
Here is how it works:
You take hormone medication to stimulate your ovaries to produce more eggs in one cycle.
The eggs are collected in a quick, minor procedure.
In the lab, your eggs are fertilised with sperm to create embryos.
Doctors monitor the embryos and choose the best one for transfer.
One embryo is then placed into your uterus to try to achieve pregnancy.
If more than one healthy embryo is created, you can freeze the extras for future use. IVF gives doctors a chance to work with the best possible eggs and embryos, which is especially helpful if time or egg supply is limited.
This test checks whether an embryo has the correct number of chromosomes.
Embryos with the right number are called euploid and are more likely to lead to a healthy pregnancy. PGT-A helps your doctor choose the most viable embryo for transfer, which can reduce the time to pregnancy and lower the risk of miscarriage.
If more than one healthy embryo is created, you can freeze the extras for future use. IVF gives doctors a chance to work with the best possible eggs and embryos, which is especially helpful if time or egg supply is limited.
Egg freezing
Egg freezing allows you to preserve your eggs while they are of better quality, giving you the option to try for a baby later.
The process is very similar to the first part of IVF:
Your ovaries are stimulated to produce multiple eggs.
The eggs are collected and frozen before fertilisation.
When you are ready to use them, the eggs are thawed, fertilised, and transferred through IVF.
Egg freezing is especially useful if:
You are not ready to have children yet but want to keep your options open.
You have a low ovarian reserve and want to preserve what you have now.
You are starting medical treatment (like chemotherapy) that may affect fertility.
Both IVF and egg freezing do not change your egg count, but they allow you to make the most of the eggs you do have. A fertility specialist can help you decide which approach fits your goals, timeline, and health.
Key takeaways
Understanding your ovarian reserve is essential for making informed decisions about your fertility and reproductive health.
Tests like the antral follicle count, FSH blood tests, and AMH lab tests provide crucial insights.
If you’re concerned about your fertility, consult with a fertility specialist who can guide you through your options and next steps.
At Ferticentro, we’re experts in fertility care and here to support you every step of the way. Whether you’re just starting out or planning your next move, we’ll help you make informed, confident decisions about your future.
To provide the best experiences, we use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us to process data such as browsing behaviour or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions.
Functional
Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
